Identify the key factors influencing children’s eating habits and attitudes toward food during middle childhood.
Explain the role of school meal programs and nutrition campaigns in supporting child development.
Compare typical energy and nutrient needs for school-aged children by age, gender, and activity level.
Distinguish between food allergies and food intolerances, including symptoms and common treatment strategies.
Healthy Eating
Several factors can influence children’s eating habits and attitudes toward food. The family environment, societal trends, taste preferences, and messages in the media all influence the emotions that children develop regarding their diet. Television commercials can entice children to consume sugary products, fatty fast foods, excess calories, refined ingredients, and high sodium levels. Therefore, parents and caregivers must direct children toward healthy choices. 5
At this stage in a child’s life, parents and other caregivers have the opportunity to reinforce good eating habits and introduce new foods into the diet, all while being mindful of the child’s preferences. Parents should also serve as role models for their children, who will often mimic their behavior and eating habits. Parents must continue to help their school-aged child establish healthy eating habits and attitudes toward food. Their primary role is to introduce a wide variety of health-promoting foods into the home, allowing their children to make informed choices.6
Our diet has changed drastically as processed foods, which did not exist a century ago, and animal-based foods now account for a large percentage of our calories. Not only has what we eat changed, but the amount of it that we consume has also dramatically increased, as plates and portion sizes have grown significantly larger. All of these choices impact our health, with short- and long-term consequences as we age. Possible short-term effects include excessive weight gain and constipation. The possible long-term effects, primarily related to obesity, include the risk of cardiovascular disease, diabetes, hypertension, as well as other health and emotional problems for children. Centers for Disease Control and Prevention. “Overweight and Obesity: Health Consequences.”8
During middle childhood, a healthy diet supports physical and mental development, promoting overall health and wellness. School-aged children experience steady, consistent growth, but at a slower rate than they did in early childhood. This slowed growth rate can have to last a lasting impact if nutritional, caloric, and activity levels aren't adjusted in middle childhood which can lead to excessive weight gain early in life and can lead to obesity into adolescence and adulthood.9
One way to encourage children to eat healthy foods is to make meal and snack time fun and interesting. Parents should include children in food planning and preparation, for example, selecting items while grocery shopping or helping to prepare part of a meal, such as making a salad. At this time, parents can also educate children about kitchen safety. It might be helpful to cut sandwiches, meats, or pancakes into small or interesting shapes. In addition, parents should offer nutritious desserts, such as fresh fruits, instead of calorie-laden cookies, cakes, salty snacks, and ice cream. Studies show that children who eat family meals on a frequent basis consume more nutritious foods.11
School Lunch Programs
Many school-age children eat breakfast, snacks, and lunch at their schools. Therefore, schools need to provide nutritionally sound meals. In the United States, more than 31 million children from low-income families receive meals provided by the National School Lunch Program. This federally funded program provides low-cost or free breakfast, snacks, and lunches to schools. School districts that participate receive subsidies from the US Department of Agriculture (USDA) for every meal they serve that meets the 2015 Dietary Guidelines for Americans.
Knowing that many children in the United States receive free or subsidized lunches in the school cafeteria, it may be worthwhile to examine the nutritional content of these meals. You can obtain this information through your local school district’s website. An example of a school menu from a school district in north-central Texas is a meal consisting of pasta Alfredo, a breadstick, peach cup, tomato soup, a brownie, and 2% milk, which complies with Federal Nutritional Guidelines. Consider another menu from an elementary school in Washington state. This sample meal consists of a chicken burger, tater tots, fruit, veggies, and 1% or nonfat milk. This meal is also in compliance with Federal Nutrition Guidelines, but has about 300 fewer calories than the menu in Texas. There is a significant difference in the calories and nutritional value of these prepared lunches, which are chosen and approved by officials on behalf of children in these districts.
Healthy School Lunch Campaigns help to promote children’s health. This is done by educating government officials, school officials, food-service workers, and parents, and is sponsored by the Physicians Committee for Responsible Medicine. They educate and encourage schools to offer low-fat, cholesterol-free options in school cafeterias and in vending machines, and work to improve the food served to children at school. Unfortunately, many school districts in the nation allow students to purchase chips, cookies, and ice cream along with their meals. These districts rely on the sale of these items in the lunchrooms to earn additional revenues. Not only are they making money off of children and families with junk food, but they are also adding additional empty calories to their daily intake. These districts should review their menus and determine the rationale for offering additional snacks and desserts to children at their schools. Whether children receive free lunches, buy their own, or bring their lunch from home, quality nutrition is what is best for these growing bodies and minds.17
Energy
Children’s energy needs vary, depending on their growth and level of physical activity. Energy requirements also vary according to gender. Girls require 1,200 to 1,400 calories per day from age 2 to 8 and 1,400 to 1,800 calories from age 9 to 13. Boys also need 1,200 to 1,400 calories daily from ages 4 to 8, but their daily caloric needs increase to 1,600-2,000 from ages 9 to 13. This range represents individual differences, including the child's level of activity.12
Recommended intakes of macronutrients (protein, carbohydrates, and fats) and most micronutrients (vitamins and minerals) are higher relative to body size, compared with nutrient needs during adulthood. Therefore, children should be provided nutrient-dense food at meal and snack time. However, it is important not to overfeed children, as this can lead to childhood obesity, which is discussed in the next section.
Food Allergies and Food Intolerance
Food intolerance and food allergies are issues for some school-aged children. Recent studies indicate that approximately three million children under the age of eighteen are allergic to at least one type of food. Some of the most common food allergies are caused by foods such as peanuts, milk, eggs, soy, wheat, and shellfish. An allergy occurs when a protein in food triggers an immune response, resulting in the release of antibodies, histamine, and other mediators that attack foreign bodies. Possible symptoms include itchy skin, hives, abdominal pain, vomiting, diarrhea, and nausea. Symptoms usually develop within minutes to hours after consuming a food allergen. Children can outgrow a food allergy, especially allergies to wheat, milk, eggs, or soy.19
Anaphylaxis is a life-threatening reaction that results in difficulty breathing, swelling in the mouth and throat, decreased blood pressure, shock, or even death. Milk, eggs, wheat, soybeans, fish, shellfish, peanuts, and tree nuts are the most common food allergens that trigger this type of response. A dose of the drug epinephrine is often administered via a “pen” to treat a person who goes into anaphylactic shock.20
Some children experience a food intolerance, which does not involve an immune response. A food intolerance is marked by unpleasant symptoms that occur after consuming certain foods. Lactose intolerance, though rare in very young children, is one example. Children who suffer from this condition experience an adverse reaction to the lactose in milk products. It is a result of the small intestine’s inability to produce enough of the enzyme lactase. Symptoms of lactose intolerance usually affect the gastrointestinal tract and can include bloating, abdominal pain, gas, nausea, and diarrhea. An intolerance is best managed by making dietary changes and avoiding any foods that trigger the reaction.22
References, Contributors and Attributions
5. Research on the Benefits of Family Meals. Dakota County, Minnesota. . Updated April 30, 2012. Accessed December 4, 2017.
